Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Normal  overjet and overbite achieved
• Midlines coincident
• Arches aligned and coordinated

Comments

• The patient's chief complaint was the inability to fully close her lips and the crowding of her teeth.
• Four second premolars were extracted.
• In this case, only Invisalign aligners and attachments were used.
• No TADs, power arms, intra-oral elastics or any other auxiliaries were used.
• A different staging technique was used for this case: Class 1 relationship was initially achieved in the canines. During the attainment of Class 1 relationship, anterior crowding was corrected with a relieving movement in combination with the retraction movement of incisors.
• Once Class 1 relationship was achieved for the canines, the movement of the first molars began. When the first molars were on their half-way, second molars start to move.
• Anterior and posterior regions were not moved simultaneously to avoid the bowing effect.
• Standard oblique rectangular attachments were used to prevent mesial tipping of the posterior teeth.
• 1.8 was extracted before refinement.
• 3.9 mm for 4.6, 2.8 mm for 3.6, 2.3 mm for 1.6 and 2 mm for 2.6 mesialization movement (challenging movement) was achieved in this case only with the use of attachments and aligners.